Effect Of Two Ways Of Hysteromyomectomy On Pregnancy

Objective: To observe the incidence and types of complications of transabdominal and laparoscopic myomectomy,and to explore the effect of transabdominal and laparoscopic myomectomy on pregnancy outcome Objective: to study the influential factors of pregnancy after transabdominal and laparoscopic myomectomy.Methods: This study was divided into two parts.The first part was to analyze the complications of myomectomy by different ways.Methods: a total of 92 patients with HYSTEROMYOMA who underwent surgical treatment from January 2010 to December 2018 were divided into two groups: Transabdominal Group(46 cases)and laparoscopic group(46 cases),the incidence and types of postoperative complications were compared between the two methods,and the two methods were compared.The second part is the analysis of pregnancy after removal of Hysteromyoma by two ways.92 patients with Hysteromyoma who were admitted to hospital from January 2010 to December 2018 were divided into two groups: 46 patients in transabdominal group and 46 patients in laparoscopic group,the related indexes and pregnancy outcome were compared between the two groups.Results: The intraoperative bleeding was 204.22 ± 18.57 ml in the transabdominal group,159.38 ± 24.73 ml in the laparoscopic group,85.43 ± 10.37 min in the transabdominal group,74.59 ± 8.78 min in the laparoscopic group,and 6.73 ± 0.59 d in the transabdominal group,the length of stay was 5.8 ± 0.47 days in the laparoscopic group,38.52 ± 4.63 hours in the transabdominal group and 27.89 ± 5.2 hours in the laparoscopic group.There were significant differences in blood loss,operation time,hospital stay and anal exhaust time between the two groups(p < 0.05).There were 2 cases of vaginal bleeding(4.35%),2 cases of poor wound healing(4.35%),4 cases of urinary retention(8.7%)and 0 cases of subcutaneous emphysema.The total complication rate was 17.4%(8 cases).In laparoscopic group,there was 1 case of vaginal bleeding(2.2%),0 cases of poor wound healing,0 cases of urinary retention and 1 case of subcutaneous emphysema(2.2%).The total complication rate was 4.35% in 2 cases.There was significant difference between the two groups(p <0.05).There was no significant difference(p > 0.05)between the two groups in the number of pregnancy preparation time(4.53 ± 2.98 years)and that between the two groups(4.03 ± 3.12 years),there was no significant difference between groups(P > 0.05)in 3 cases(6.52%)of abortion,5 cases(10.87%)of preterm delivery,4 cases(8.70%)of preterm delivery in laparoscopic group(P > 0.05)There were 37 cases(80.43%)of full term delivery in transabdominal group and 39 cases(84.78%)in laparoscopic group.There was no significant difference(P > 0.05).In short,the bleeding volume,operation time,hospital stay and anal exhaust time in laparoscopic group were better than those in transabdominal group(p < 0.05).The incidence of vaginal bleeding,poor wound healing,urinary retention and subcutaneous emphysema in laparoscopic group was significantly lower than that in transabdominal group(p < 0.05).There was no significant difference in pregnancy outcome between the two groups(P > 0.05).Conclusion: Compared with transabdominal myomectomy,laparoscopic myomectomy has the advantages of less trauma,less bleeding and less postoperative complications.